MATURE MARKET HEADLINES POSTED 04/24/98
Gatekeeper Program Identifies Isolated Elders
Director Maralee I. Lindley of the Illinois Department on Aging announced that members of the Metropolitan Chicago Healthcare Council, composed of nearly 40 hospitals and health organizations in the Chicago area, are participating in a statewide program that helps identify older persons in need.
"Through the State's Gatekeeper Program, personnel in various hospitals, community agencies and businesses are trained to be on the lookout for older persons who need help," said Lindley. "If gatekeepers suspect a problem, they call an office on aging, and local professionals follow up to see what assistance might be needed. "An overgrown lawn, mail piling up, problems with physical coordination, confusion or extreme anxiety are all signals that an older person is in trouble.
By reporting such circumstances, gatekeepers can often prevent a crisis from happening," Lindley said. A phone call to the Illinois Department on Aging or Chicago Department on Aging will result in assistance that could include services such as personal care, housekeeping assistance, meals, or transportation. The cooperation of such a comprehensive effort will be instrumental helping isolated older persons to maintain their dignity and independence. Crisis prevention is one of the most cost-effective strategies in elder care.
AgeVenture News Service, www.demko.com
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Aspirin Alone Protects Some From Stroke
Doctors may be closer to preventing the nearly two million strokes that occur due to atrial fibrillation (AF). Atrial fibrillation is an irregular and rapid contractions of the atria, the upper chamber of each half of the heart. The right atrium receives blood from throughout the body which has been used to deliver oxygen and food to the cells, and now returns to the heart so it can be replenished. The left atrium receives blood from the lungs that has been replenished with oxygen.
When this delicate balance of nature is upset, the patient has a high risk of ischemic stroke. Ischemia refers to a temporary reduction in blood to the body. The special challenge for doctors is identifying those patients who fall into this high-risk category, so they can be given proper treatment. Now, according to an article in the April 22 issue of The Journal of the American Medical Association (JAMA), AF patients who do not have additional risk factors for stroke and do not have high blood pressure may be able to protect against stroke by taking aspirin and discontinuing other anticoagulants.
That's great news. So, medical investigators are working on creating a "stroke risk stratification system" to identify AF patients who can be protected against stroke through the use of aspirin. However, on a cautionary note, the efficacy of aspirin for preventing stroke in AF patients is controversial. Although clearly less effective than warfarin therapy for prevention of ischemic events, treatment with aspirin carries a lower risk of bleeding.
Those concerned about the gastrointestinal risks of aspirin use should see AgeVenture articles on ulcer risk and ulcer origin. Regarding the AMA article, the Committee on Stroke Prevention in AF patients writes: "These results suggest that patients with AF can be prospectively identified who have a low risk of stroke, particularly disabling ischemic stroke, when taking aspirin.
Such patients may not benefit substantially from treatment with warfarin, since their rate of stroke during aspirin therapy is sufficiently low that warfarin could only minimally reduce the absolute rate of stroke." Several clinical trials have demonstrated that treatment with adjusted-dose warfarin reduces the risk of stroke in AF patients by about two-thirds, leading to current recommendations that most AF patients receive life-long anticoagulation.
The researchers found that for AF patients without a history of hypertension or any of the four specific risk factors for blood clots, the rate of ischemic stroke was similar to that of the general population. The four thromboembolic risk factors are:
- (1) impaired left ventricular function;
- (2) systolic blood pressure higher than 160 mm Hg;
- (3) prior ischemic stroke, transient ischemic attack (TIA) or systemic embolism; or
- (4) female and older than 75 years.
In contrast, AF patients with one or more of the risk factors who entered a separate randomized trial component of the Stroke Prevention in AF Study had much higher rates of stroke (averaging eight percent per year), even when treated with aspirin in combination with low doses of warfarin. The authors of the AMA article state: "A substantial fraction of the patients with AF, identifiable by specific clinical criteria, have low rates of thromboembolism during aspirin therapy and benefit much less from anticoagulation therapy than would high-risk AF patients."
AgeVenture News Service, www.demko.com
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Motown Gets Ready To Hit the Big "Four - O"
This year, Motown Records is celebrating its 40th year as an entertainment industry giant. Entrepreneur, Berry Gordy Jr. started the record company with an $800 loan back in 1959. Today, the record company is credited with launching many legends of the music industry such as the Temptations, Stevie Wonder, the Supremes, Mary Wells, the Marvelettes, and Smoky Robinson and the Miracles. In 1966, Motown's Temptations blistered the soul charts with four consecutive Number One hits: "Get Ready", "Ain't Too Proud To Beg", "Beauty Is Only Skin Deep", and "I'm Losing You".
At the same time, Motown's Supreme's, Four Tops, and Stevie Wonder also scored with Number One singles. Gordy spawned a leadership style that attributed to Motown's unique and unprecedented success. He would assemble staff from various departments to listen to a newly recorded song and then as for comments. This kept the music close to the people and the people close to the creative side of the music industry. In 1972, Stevie Wonder's "Superstition" was Number One for three weeks. It was that year that Motown relocated to new offices in Hollywood, California.
However, a small staff remained at the Detroit recording studio where most of the artists still recorded their best work. By 1995, Motown had again relocated its headquarters, this time in New York. Two years later, the current CEO George Jackson took the helm of the company, turning his attention to Motown's rich archives of previously unheard recordings, gospel, and hard-to-find classics. For example, the archives include duet recordings with Stevie Wonder and Levi Stubbs (Four Tops).
The huge archival effort was ably supervised by Georgia Ward, the only employee currently working at Motown who was with the company in its earliest days, when the fledging company was still headquartered in the motor town of Detroit, Michigan. Ward, now 62, is profiled in AgeVenture's Super Senior lifestyle section.
Source: Elise Wright, Motown Record Company.
AgeVenture News Service, www.demko.com
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Active Rich Shape Japanese Financial Market
Finding financial certainty in an uncertain world is a major concern for those now retired, as well as, those who hope to retire in the future. A new sense of self-reliance and personal initiative seems to be emerging in financial markets. Americans wonder if public and private pensions can be depended on to be there for them in the future.
The growing numbers of elderly and retired who place substantial burdens on already strained social institutions seem to fuel uncertainty about the future. Just as America's baby boomers are scrambling to build their retirement nest-egg, and retirees are working to protect their retirement savings, their Japanese counterparts seem to be focusing on similar issues.
Tokyo-based Dentsu Inc has released a report analyzing its "Survey of Asset Management by High-Income Households". In its report, Dentsu identified the high-income households (those whose earnings exceed 15 million yen a year), as the "active rich". This group expressed keen interest in asset management. The report found that most of the high-income households were gathering information from the mass media and independently making judgments about financial institutions and products. They show particular interest in such instruments as foreign bonds and foreign currency deposits, and are willing to take a higher degree of risk.
Moreover, they are extremely positive about the changes that will follow implementation of the amended Foreign Exchange Law. In their future choices of financial institutions, the respondents say they will pay serious attention to such issues as quality of product/service, interest rates and management stability.
Dentsu plans to use its expertise on brand-building to employ the survey data to develop and propose appropriate ways for individual financial institutions to handle their marketing communications. As increasing numbers in the mature market continue to line up for financial products on both sides of the Pacific, it will be interesting to watch for marketing and product parallels among Japanese financial institutions and America's new Super Banks.
AgeVenture News Service, www.demko.com
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Scientists Search for Meaning of Menopause
Does the physiological process of menopause carry a psycho-social benefit for the family unit? That's an interesting question when you think about the function of human aging and its intended consequences for humankind. Menopause is a simple consequence of growing old, not an adaptation that allows females to devote their energies to the success of their grandchildren, according to Craig Packer, University of Minnesota. In female mammals, fertility declines abruptly at a certain age.
The reason why menopause happens at all is a matter of debate. Some suggest that it has evolved as a trade-off, in which aging females avoid the increasing complications and risks of childbirth to better nurture their children and grandchildren. Packer and colleagues puncture this idea in their report, showing that menopause is just a consequence of aging, pure and simple, with no strings attached. If menopause allowed elderly females to indulge their offspring, the results should be an increased measure of reproductive success for those offspring.
However, girls with grannies are likely to raise more offspring than girls without grannies. Packer and colleagues (Nature April 1998) tested this idea with two species - baboons and lions -- in which females show abrupt age-specific changes in reproductive performance, and in which grandmothers frequently engage in what the researchers call "kin-directed behavior".
The researchers show, first, that there is no trade-off between age and reproductive success. In other words, females that produce a lot of offspring are no more likely to suffer an early death than those who had produced fewer offspring. Second, the presence of post-reproductive females does not seem to enhance the reproductive success of grandchildren or older children. Seems like the jury is still out when it comes to a psycho-social basis for the physiological process known as menopause. Back to the proverbial drawing board.
AgeVenture News Service, www.demko.com
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